容积CT主动脉根部结构及其动态变化的影像学研究  

The Clinical Investigation of Anatomy of Aortic Root and Its Variation Using Volume CT

作　　者：黄小勇[1] 黄连军[1] 薛玉国[1] 濮欣[1] 郭曦[1] 李勐[1] 

机构地区：[1]首都医科大学附属北京安贞医院医学影像科,北京100029

出　　处：《临床放射学杂志》2012年第4期501-505,共5页Journal of Clinical Radiology

基　　金：首都医学发展科研基金项目(编号:2009-3115)

摘　　要：目的应用容积CT全心动周期成像技术探讨正常主动脉根部解剖结构及其动态变化规律。资料与方法 2011年3月至8月间共50名来本院体检的正常成人,行单容积全心动周期CT心脏成像,所得影像资料经多期重组及相应后处理心功能分析软件处理,测量主动脉窦管交界以远2 cm、1 cm处主动脉内径(A2、A1),窦管交界部内径(B),主动脉窦内径(S),主动脉瓣环内径(O),左、右冠状动脉开口至同侧窦底垂直距离(L、R),并分析其在左室收缩末期和舒张末期之间、同期轴位前后径与左右径之间的变化规律,测量左室射血分数(LVEF),左室心肌质量(LV mass)及主动脉瓣开放面积、主动脉瓣环面积等参数。结果 (1)两名测量者对主动脉根部各径线测量结果一致性良好(r=0.765～0.803,P>0.05);(2)主动脉窦管交界以远2 cm处内径(A2)在左室收缩末期和舒张末期间差异有统计学意义(t=3.100、2.622,P<0.05);轴位测量窦管交界水平(S)同期相主动脉前后径(a-p)与左右径(r-l)测量值差异无统计学意义(t=0.418、-0.030,P>0.05);正常左右冠状动脉开口至同侧窦底收缩末期及舒张末期距离分别为(15.36±2.13)mm、(15.46±2.29)mm和(13.31±3.01)mm、(13.64±2.59)mm,且在全心动周期内变化差异无统计学意义(t=-0.274、-1.169,P>0.05);高度差均数为1.827 mm;(3)左室平均射血分数(67.00±4.40)%,平均左心室心肌质量(129.01±28.90)g,平均主动脉瓣口开放面积(323.64±78.94)mm2,平均主动脉瓣环面积(462.09±76.23)mm2,平均主动脉窦面积(916.36±209.93)mm2。结论应用容积CT全心动周期采集模式可以分析主动脉根部细微结构及其动态变化规律,并测量左心室功能,在主动脉根部病变诊治领域有着良好的应用前景。Objective To assess the normal aortic root anatomical structure and its variation using volume CT.Materials and Methods 50 healthy volunteers during Mar.2011 to Aug.2011 received cardiac volume CT scan.Multi periods reconstruction,post processing and cardiac function analysis software were used.The dimensions of the aortic root and the parameters of left ventricular function were measured,and the variation of the aortic root between left ventricular end systolic and end diastolic phases was analyzed.Results（1）The introobserver agreement was good in the dimensions of aortic root measurements（r=0.765-0.803,P〈0.05）;（2）There was significant difference in aorta diameter at the level of 2 cm away from sinotublar junction（A2） between end diastolic and end systolic phase（t=3.100、2.622,P〈0.05）;compared the anteroposterior and transverse diameters of aortic sinotublar junction level at the same phase,there was no significant difference（t=0.418、-0.030,P〈0.05）;the dimensions of left and right coronary osmiums to their sinus base were（15.36±2.13） mm,（15.46±2.29） mm and（13.31±3.01） mm,（13.64±2.59） mm respectively,which were no significant difference between left ventricular end diastolic and end systolic phase.Mean height difference was 1.827 mm;（3）The mean ejection fraction（EF value） was（67.00±4.40）%,the mean left ventricular myocardial mass was（129.01±28.90）g,the mean aortic orifice area was（323.64±78.94） mm2,the mean aortic annulus area was（462.09±76.23） mm2,the mean aortic sinus area was（916.36±209.93） mm2.Conclusion Cardiac volume CT can precisely analyze not only the anatomy and variation of aortic root,but also evaluate the LV function,which has a wide application prospect in the diagnosis and treatment of aortic root diseases.

关 键 词：主动脉根部 主动脉瓣 心功能 心脏 体层摄影术 X线计算机 

分 类 号：R816.2[医药卫生—放射医学]